Immunohistochemical evaluation of a panel of tumor cell markers during malignant progression in Barrett esophagus

Am J Clin Pathol. 2008 Nov;130(5):745-53. doi: 10.1309/AJCPO31THGVEUIDH.

Abstract

Histopathologic grading of dysplasia in Barrett esophagus (BE) shows substantial interobserver and intraobserver variation. We used immunohistochemical analysis with a set of tumor cell markers, ie, epidermal growth factor receptor (EGFR), ERBB2 (HER2/neu), MYC, CDKN2A (p16), SMAD4, MET, CCND1 (cyclin D1), CTNNB1 (beta-catenin), and TP53 (p53), in histologic sections of endoscopic biopsies of 86 patients with BE in various stages of neoplastic progression. The markers, except SMAD4, were scored as 0 (<1% of cells stained), 1 (1%-25%), 2 (26%-50%), or 3 (>50%). All markers, except EGFR, showed a significant trend for immunohistochemical protein overexpression during malignant progression in BE (P <.01). When the successive stages along the metaplasia-low-grade dysplasia (LGD)-high-grade dysplasia (HGD)-adenocarcinoma axis were compared, protein overexpression of beta-catenin separated LGD from metaplasia, whereas protein overexpression of cyclin D1 and p53 discriminated HGD from LGD (all P <.001). beta-Catenin can be helpful for a diagnosis of LGD in BE, although it stains positively in a subset only, whereas p53 remains an appropriate marker to define HGD. In case of doubt, cyclin D1 can be added to separate LGD from HGD in BE.

MeSH terms

  • Adenocarcinoma / etiology
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Barrett Esophagus / diagnosis
  • Barrett Esophagus / pathology*
  • Biomarkers, Tumor / analysis*
  • Cyclin D
  • Cyclins / biosynthesis
  • Disease Progression
  • Esophageal Neoplasms / etiology
  • Esophageal Neoplasms / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Tumor Suppressor Protein p53 / biosynthesis
  • beta Catenin / biosynthesis

Substances

  • Biomarkers, Tumor
  • CTNNB1 protein, human
  • Cyclin D
  • Cyclins
  • Tumor Suppressor Protein p53
  • beta Catenin